摘要:

This study tries to answer two questions: 1) how long does the therapeutic effect of successful immunotherapy (IT) last after termination of the treatment? and 2) what is the best treatment for recidivist patients? To answer the first question, we asked 108 patients with rye/grass pollen allergy who had previously undergone IT for 3–4 years and had responded well to treatment to complete a questionnaire on the course of their recovery after termination of the therapy. Evaluation of the answers revealed a recidivist rate of approximately 30% in the first 3 years. According to our results, the risk of a relapse after this period seems to be low. To answer the second question, we included 40 patients suffering from type I allergy to grass/rye pollen in a clinical study. Each of them had previously undergone specific IT with a grass pollen extract mixture and had terminated this therapy after 3–4 years practically free of symptoms during the grass pollen season. As the symptoms returned and increased from year to year after the end of IT, new therapeutic steps had to be considered. We investigated the efficacy of a short preseasonal injection treatment called “booster immunotherapy” (BIT). BIT was performed with two different injection‐regimens, a low‐dose schedule comprising six injections and a high‐dose schedule with 11 injections, in both cases administered as a build‐up regimen. In the next pollen season, 28/40 (70%) patients reported strong improvement or even complete remission of the allergy symptoms. All patients showed a distinct change in their response to provocation tests and in IgG4 antibody liters; however, no correlation between improvedin vivoorin vitrotests and effectiveness of the therapy could be observed. The results show the efficacy of both booster schedules, and we therefore recommend BIT as a valid alternative to repeating conventiona

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1994.tb00771.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The ability of aspirin and other nonsteroidal anti‐inflammatory drugs (NSAIDs) to inhibit the cyclo‐oxygenase which catalyzes formation of prostaglandins appears to be central to the mechanisms involved in aspirin sensitivity. We have investigated whether the plasma levels of acetylsalicylic acid (ASA) and its main metabolite salicylic acid (SA) at the time of intolerance reactions correspond with the concentrations required for enzyme inhibitionin vitro.Twelve aspirin‐sensitive and 15 aspirin‐tolerant subjects were followed during provocation with aspirin. ASA and SA concentrations in plasma were determined by HPLC. After oral provocation (up to 460 mg cumulative dose), the levels of ASA and SA in plasma were equivalent in aspirin‐sensitive and aspirin‐tolerant subjects. For the aspirin‐sensitive subjects, at the time of adverse reaction, the concentration range was 2.9–33.3 μM for ASA and 18.1–245 μM for SA. Oral provocation with sodium salicylate yielding 10‐fold higher SA levels did not elicit intolerance reactions. Statistically significantly lower levels of ASA and SA (P>0.01) evoked airway obstruction, as compared with merely extrapulmonary symptoms. Bronchial absorption of aspirin was found after inhalation of lysine‐aspirin and was comparable in asthmatic and nonasthmatic subjects. In three aspirin‐sensitive subjects who developed airway obstruction, the plasma levels for ASA and SA were 0.9–2.6 μM and 0.0–6.7 μM, respectively. In conclusion, the plasma levels of ASA reached at the time of a positive reaction are of the magnitude known to inhibit cyclo‐oxygenases. Neither differences in bioavailability of ASA nor the formation of SA seems to contribute

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1994.tb00772.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The yeastPityrosporum orbiculare (P. orbiculare)is a member of the normal human cutaneous flora, but it is also associated with several clinical manifestations of the skin. We have previously observed IgE‐binding components inP. orbiculareextracts, using sera from patients with atopic dermatitis. In the present study, we raised several monoclonal antibodies (MoAbs) againstP. orbiculareto characterize some of its antigens, and usedCandida albicans (C. albicans)as a control. We obtained several IgGI MoAbs which specifically recognizedP. orbicularein ELISA. Two of these were selected for immunoblotting studies onP. orbiculareand two patterns of reactivity emerged. Firstly, one MoAb showed a distinct band at a molecular mass of 67 kDa. In the second pattern, a sharp band at about 37 kDa appeared. In contrast, the IgM antibodies raised reacted with a 14‐kDa component; but they reacted withC. albicansin addition toP. orbiculareThe IgGI antibodies seemed to react with proteins, as their ability to react in ELISA with extract pretreated with protease was greatly reduced. In contrast, IgM MoAbs were much less affected, suggesting that they recognized nonprotein components. To determine whether these MoAbs‐binding components were also recognized by human IgE, we adopted a radioimmunoassay (RIA) using the MoAbs as catcher antibodies. Both the 67‐kDa and the 37‐kDa components were IgE‐binding proteins.P. orbicularRAST positive sera were scored as positive in the RIA, whereas the control se

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1994.tb00773.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Immune‐mediated reactions to NSAIDs are unusual. We have observed two cases of maculopapular eruptions occurring 48–72 h after administration of diclofenac sodium. Patch tests performed with diclofenac were positive. The histopathologic findings resembled those of contact dermatitis with different degrees of dermal involvement. Clinical, allergologic, and histopathologic patterns strongly suggest a type IV mechanism of hypersensitivity. Patch tests play an important role in the assessment of possible immunologic mechanisms underlying cutaneous reactions to dr

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1994.tb00774.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Levels of platelet‐activating factor (PAF) in blood from 12 bronchial asthmatic patients (six atopic and six nonatopic) were measured by radioimmunoassay after lipid extraction and separation by high‐performance liquid chromatography. None of the patients were given disodium cromoglycate and prednisolone, and they were instructed to take only regular medications during the tests. Blood was drawn from the patients in a fasting state, and PAF levels were compared between the times when they were free of asthmatic symptoms and when they had mild spontaneous attacks. Ten (six atopic and four nonatopic) out of 12 patients, when they had the asthmatic attacks, showed higher levels of PAF than when they were free of the symptoms. Blood PAF levels of the patients with the active symptoms were significantly higher than those of normal healthy control subjects, suggesting that PAF may play a role in bronchial ast

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1994.tb00775.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Several epidemiologic studies suggest that in mite‐sensitive patients symptoms are dependent upon mite‐exposure level. However, in clinical practice, it is not easy to measure major mite allergens. In contrast, assay of specific IgE antibodies can be done routinely. Thus, we wanted to compare, in a group of 40 mite‐sensitive patients, the levels of mite‐specific IgE (measured by RAST grade 0–6) and the level of mite group I allergen in mattresses (measured in μg/g house dust). The correlation coefficient between both variables was highly significant (P= 0.001). Subjects with a RAST grade of 3 or more had a 77% probability of being exposed to high (i.e.,<10 μg/g dust) mite allergen level. In contrast, subjects with RAST grades 0, 1, or 2 had a 77% probability of not being exposed to such high levels. Thus, measurement of serum mite‐specific IgE level could be used in routine prediction of

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1994.tb00776.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0105-4538    

DOI:10.1111/j.1398-9995.1994.tb00777.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY